Cultural Transformation After Implementation of Crew Resource Management: Is It Really Possible?

Hefner, Jennifer L; Hilligoss, Brian; Knupp, Amy M.; Bournique, Judy; Sullivan, John E.; Adkins, Eric; Moffatt-Bruce, Susan D.

doi:10.1177/1062860616655424

Cited by 35 publications

(51 citation statements)

References 22 publications

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“…Burström, Letterstål, Engström, Berglund, and Enlund (2014) identified the same effect, with the most prominent changes seen in teamwork and communication openness, while Curry et al (2017) reported substantial between-hospital differences when measuring changes in safety culture during a 2-year interventional study. Crew resource management (CRM) also showed potential for improving safety culture over a 2-year study period (Hefner et al, 2017). Interventions such as training can improve nurses' perceptions of safety culture (Ginsburg et al, 2009;Weaver et al, 2013) and establish a proactive, patient-centred infrastructure in which nonpunitive responses to errors will continuously improve the patient safety culture.…”

Section: Discussionmentioning

confidence: 99%

Changes in patient safety culture: A patient safety intervention for Finnish forensic psychiatric hospital staff

et al. 2019

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Aim To evaluate how a 3‐year patient safety intervention, more specifically, the implementation of a patient safety incident reporting system, influences patient safety culture. Background Positive patient safety culture improves both the quality of health care and patient safety. Nevertheless, nursing managers need tools that can help them develop and evaluate patient safety culture. Methods The Hospital Survey on Patient Safety Culture was used to evaluate patient safety culture at two Finnish forensic psychiatric hospitals (study and control) over two periods, baseline and follow‐up. Data were analysed using Z‐score and T test statistics. Results The follow‐up results from the study hospital showed that five patient safety culture dimensions exhibited a significantly (p < 0.05) positive change in positive response rates over the 3‐year period. Furthermore, nine out of twelve patient safety culture dimensions at the study hospital showed a significant improvement in mean score. At the control hospital, only the dimension of frequency of reporting events showed a significantly positive change (p < 0.05) in mean score. Conclusion This research shows that the studied patient safety intervention (implementation of the patient safety incident reporting system) significantly influences patient safety culture. Implications for Nursing Management Nursing managers should utilize a variety of patient safety interventions to improve patient safety and focus on leveraging information from patient safety incidents to advance patient safety culture.

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Section: Discussionmentioning

confidence: 99%

Changes in patient safety culture: A patient safety intervention for Finnish forensic psychiatric hospital staff

et al. 2019

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“…Similar findings of improvement especially in teamwork and communication, after CRM implementation, were reported recently. These results are based on the Hospital Survey on Patient Safety Culture (HSOPS) pre‐ and post‐CRM implementation across eight departments spanning three hospitals and two campuses …”

Section: Discussionmentioning

confidence: 99%

The effects of crew resource management on teamwork and safety climate at Veterans Health Administration facilities

Schwartz

Welsh

Paull

et al. 2017

J of Healthc Risk Manag

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Communication failure is a significant source of adverse events in health care and a leading root cause of sentinel events reported to the Joint Commission. The Veterans Health Administration National Center for Patient Safety established Clinical Team Training (CTT) as a comprehensive program to enhance patient safety and to improve communication and teamwork among health care professionals. CTT is based on techniques used in aviation's Crew Resource Management (CRM) training. The aviation industry has reached a significant safety record in large part related to the culture change generated by CRM and sustained by its recurrent implementation. This article focuses on the improvement of communication, teamwork, and patient safety by utilizing a standardized, CRM-based, interprofessional, immersive training in diverse clinical areas. The Teamwork and Safety Climate Questionnaire was used to evaluate safety climate before and after CTT. The scores for all of the 27 questions on the questionnaire showed an increase from baseline to 12 months, and 11 of those increases were statistically significant. A recurrent training is recommended to maintain the positive outcomes. CTT enhances patient safety and reduces risk of patient harm by improving teamwork and facilitating clear, concise, specific and timely communication among health care professionals.

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“…For example, Hefner et al [48] evaluated the impact on PSC of implementing Crew Resource Management (CRM), a strategy that is being used to strengthen PSC by applying a systematic approach to training teams in interpersonal communication, teamwork, leadership and decision-making [54]. One quasi-experimental study [38] evaluated how training applied to a set of 23 hospitals impacted PSC and then compared this with a static group of 14 hospitals.…”

Section: Discussionmentioning

confidence: 99%

“…-- [28,40,42,44,45]; (iv) four studies evaluated the effects on PSC of investments in improving the quality and safety of healthcare at hospitals [17,20,38,48]; (v) two studies investigated associations between safety culture and outcome variables [21,32] and (vi) one study [46] evaluated safety culture among hospital staffs and made comparisons with studies in other countries.…”

Section: 'Teamwork Within Units' (78%)mentioning

confidence: 99%

“…Of those that did not contemplate the STROBE criteria; four presented no descriptive statistics on the participants [17,26,31,48]; three did not state the study participant inclusion criteria [29,44,45]; two failed to specify the data collection period [19,46]; two did not discuss the study's external validity or limitations [34,40]; one did not state the study design in their title or abstract [42]; one did not report the response rate [41]; one stated neither the data collection period nor descriptive statistics on the participants [43]; one did not discuss the study's limitations [21]; one stated neither the inclusion criteria, how data were collected, response rate nor the study's limitations [47]; one did not give descriptive statistics on the participants nor discuss its limitations and external validity [35] and lastly, one study did not give descriptive statistics on its participants or information on sample size and response rate [20] (Table 3).…”

Section: Quality Assessment Of the Studiesmentioning

confidence: 99%

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The patient safety culture: a systematic review by characteristics of Hospital Survey on Patient Safety Culture dimensions

Reis

Paiva

Sousa

2018

International Journal for Quality in Health Care

155

127

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Purpose: To learn the weaknesses and strengths of safety culture as expressed by the dimensions measured by the Hospital Survey on Patient Safety Culture (HSOPSC) at hospitals in the various cultural contexts. The aim of this study was to identify studies that have used the HSOPSC to collect data on safety culture at hospitals; to survey their findings in the safety culture dimensions and possible contributions to improving the quality and safety of hospital care. Data sources: Medline (via PubMed), Web of Science and Scopus were searched from 2005 to July 2016 in English, Portuguese and Spanish. Study selection: Studies were identified using specific search terms and inclusion criteria. A total of 33 articles, reporting on 21 countries, was included. Data extraction: Scores were extracted by patient safety culture dimensions assessed by the HSOPSC. The quality of the studies was evaluated by the STROBE Statement. Results: The dimensions that proved strongest were 'Teamwork within units' and 'Organisational learning-continuous improvement'. Particularly weak dimensions were 'Non-punitive response to error', 'Staffing', 'Handoffs and transitions' and 'Teamwork across units'. Conclusion: The studies revealed a predominance of hospital organisational cultures that were underdeveloped or weak as regards patient safety. For them to be effective, safety culture evaluation should be tied to strategies designed to develop safety culture hospital-wide.

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Cultural Transformation After Implementation of Crew Resource Management: Is It Really Possible?

Cited by 35 publications

References 22 publications

Changes in patient safety culture: A patient safety intervention for Finnish forensic psychiatric hospital staff

Changes in patient safety culture: A patient safety intervention for Finnish forensic psychiatric hospital staff

The effects of crew resource management on teamwork and safety climate at Veterans Health Administration facilities

The patient safety culture: a systematic review by characteristics of Hospital Survey on Patient Safety Culture dimensions

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